The Experts below are selected from a list of 171 Experts worldwide ranked by ideXlab platform
Paolo Macchiarini - One of the best experts on this subject based on the ideXlab platform.
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technique and results of hyperthermic 41 c isolated Lung perfusion with high doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
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Technique and results of hyperthermic (41°C) isolated Lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
A Wurtz - One of the best experts on this subject based on the ideXlab platform.
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surgical treatment of primary Sarcoma of the Lung
European Journal of Cardio-Thoracic Surgery, 2000Co-Authors: H Porte, David Metois, Xavier Leroy, M Conti, B Gosselin, A WurtzAbstract:Objective: To study the results of surgical treatment of primary Lung Sarcoma. Methods: Between 1982 and 1998, we performed 18 macroscopically complete resections for primary Sarcomas of the Lung. The records of all patients were reviewed, as were pathological slides. Presence of symptoms, tumour size (more or less than 5 cm), complete resection, TNM stage and histology grade were analyzed for predictors of survival. Results: Patients comprised 11 women and seven men whose age ranged from 19 to 73 years (mean 50 years). Mean tumour diameter was 8.05 cm (range 2.5‐15 cm) There were one grade 1, eight grade 2 and nine grade 3 tumours. Tumours in two patients were unresectable at first presentation, and another was of doubtful resectability according to computed tomography scan. These three patients received pre-operative chemotherapy, with a partial response in the two unresectable patients allowing macroscopically complete resection in both cases. We performed 12 lobectomies (extended to the chest wall in two cases and to the diaphragm in two cases) and six pneumonectomies (extended to the chest wall in one case and the superior vena cava in one case). Operative and 30 days postoperative mortality were nil. Resection margins were invaded in two cases. Six patients received post-operative chemo- or radiotherapy and three others underwent repeat resections for pulmonary Sarcoma recurrence. No patients were lost to follow-up. Pulmonary Sarcomas recurred in eight patients (44%) leading to death in five cases after a mean period of 17 months. Overall median survival was 48 months, and actuarial 5-year survival 43%. Only TNM stage correlated with significantly increased survival. Conclusion: As complete resection is the best therapeutic option for obtaining an acceptable survival rate in primary pulmonary Sarcoma, pre-operative chemotherapy can be a useful adjunct in increasing the resectability of these tumours. q 2000 Elsevier Science B.V. All rights reserved.
C Schroder - One of the best experts on this subject based on the ideXlab platform.
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technique and results of hyperthermic 41 c isolated Lung perfusion with high doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
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Technique and results of hyperthermic (41°C) isolated Lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
H Porte - One of the best experts on this subject based on the ideXlab platform.
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surgical treatment of primary Sarcoma of the Lung
European Journal of Cardio-Thoracic Surgery, 2000Co-Authors: H Porte, David Metois, Xavier Leroy, M Conti, B Gosselin, A WurtzAbstract:Objective: To study the results of surgical treatment of primary Lung Sarcoma. Methods: Between 1982 and 1998, we performed 18 macroscopically complete resections for primary Sarcomas of the Lung. The records of all patients were reviewed, as were pathological slides. Presence of symptoms, tumour size (more or less than 5 cm), complete resection, TNM stage and histology grade were analyzed for predictors of survival. Results: Patients comprised 11 women and seven men whose age ranged from 19 to 73 years (mean 50 years). Mean tumour diameter was 8.05 cm (range 2.5‐15 cm) There were one grade 1, eight grade 2 and nine grade 3 tumours. Tumours in two patients were unresectable at first presentation, and another was of doubtful resectability according to computed tomography scan. These three patients received pre-operative chemotherapy, with a partial response in the two unresectable patients allowing macroscopically complete resection in both cases. We performed 12 lobectomies (extended to the chest wall in two cases and to the diaphragm in two cases) and six pneumonectomies (extended to the chest wall in one case and the superior vena cava in one case). Operative and 30 days postoperative mortality were nil. Resection margins were invaded in two cases. Six patients received post-operative chemo- or radiotherapy and three others underwent repeat resections for pulmonary Sarcoma recurrence. No patients were lost to follow-up. Pulmonary Sarcomas recurred in eight patients (44%) leading to death in five cases after a mean period of 17 months. Overall median survival was 48 months, and actuarial 5-year survival 43%. Only TNM stage correlated with significantly increased survival. Conclusion: As complete resection is the best therapeutic option for obtaining an acceptable survival rate in primary pulmonary Sarcoma, pre-operative chemotherapy can be a useful adjunct in increasing the resectability of these tumours. q 2000 Elsevier Science B.V. All rights reserved.
Anne Christin Pieck - One of the best experts on this subject based on the ideXlab platform.
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technique and results of hyperthermic 41 c isolated Lung perfusion with high doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
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Technique and results of hyperthermic (41°C) isolated Lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable Lung Sarcoma metastasis
European Journal of Cardio-Thoracic Surgery, 2002Co-Authors: C Schroder, Stefan Fisher, Anne Christin Pieck, Axel Muller, Ulrich Jaehde, Hartmut Kirchner, Axel Haverich, Paolo MacchiariniAbstract:Objective: A technique of hyperthermic isolated Lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n ¼ 2) or bilateral (n ¼ 2) Sarcoma metastasis confined to a lobe (n ¼ 2) or entire Lung (n ¼ 2) entered into a pilot study of hyperthermic (418C) ILP with high doses of cisplatin (70 mg/m 2 ). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the Lung segments was carried out following metastectomy, for 20–40 min at a rate of 0.3–0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 418C or higher. Before and following ILP, the isolated Lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7 ^ 9 min perfusion time at 41.4 ^ 0.38C, and this time-point corresponded to the maximal platinum Lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as noncardiogenic edema of the treated Lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, Lung Sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. q 2002 Elsevier Science B.V. All rights reserved.
